Three department of defense‐funded public health approaches to reduce military suicide

Abstract

Background Suicide is a serious and growing public health concern, both for the United States (U.S.) and for the Department of Defense (DoD). Methods Using the social–ecological framework, we provide examples of how three newly developed, DoD‐funded pilots/programs have incorporated a public health approach to help prevent military suicide. Key Results The first two programs demonstrate how non‐clinical, community‐based approaches can be tailored to specific military subgroups at the individual, relational, and community levels. These programs include a universal suicide prevention program developed for Special Operations service members, spouses, and mental health providers, and a selective suicide prevention program pilot developed for military chaplains to support them in their role as a “gateway” to care for distressed service members, improve mental health and chaplaincy collaboration, and prevent burnout. The third program illustrates how the creation of and policy of a methodology/infrastructure to conduct standardized, theory‐driven suicide death reviews across the DoD may inform the DoD public health approach to surveillance, review, and synthesis of suicide data, informed by the social–ecological model. Potential program limitations and evaluation efforts are discussed. Conclusion Future prevention approaches should enhance coordination and communication between DoD, VA, and community organizations to enhance multi‐level suicide prevention programming for military personnel, veterans, and civilians.

Workplace interventions to prevent suicide: A scoping review

“…Of the other interventions two were described in initial and follow-up studies: i) the Israeli Defence Force Suicide Prevention Program [ 29 , 46 ] and ii) Together for Life, a suicide prevention programme for the Montreal police [ 47 , 48 ]. One study described three separate interventions [ 49 ] and the remaining interventions were described in single studies only.…”

“…Lack of time was identified as a barrier to implementation [ 49 ] whilst providing dedicated time was a facilitator [ 64 ]. Other barriers were a lack of information about the programme [ 49 ], intervention implementation diminishing over time [ 56 ] and difficulties in earning the trust of workers [ 67 ]. Facilitators of the MATES in Construction programme were promoting the programme on site [ 27 ] and being easy to engage with [ 41 ].…”

Military chaplains and mental health clinicians: Overlapping roles and collaborative opportunities.

“…Specialized military chaplain education also is emerging for evidence-based treatment of suicidality typically used by mental health clinicians. For example, the Chaplains-CARE training program was developed to provide training for chaplains in how to effectively listen to a suicidal service member, work to build hope, create a safety plan, engage the service member in problem-solving, and practice coping strategies (LaCroix et al, 2021).…”

“…Based on the examples elucidated herein, chaplains and clinicians in military care settings perform similar work and are members of connected, but separate professional communities. These examples include the Chaplains-CARE program that equips chaplains to intervene with service members at risk for suicide by building effective safety plans (LaCroix et al, 2021), the inclusion of chaplains as OSCAR extenders to provide frontline support in the Marine Corps (USMC, 2018), and the inclusion of chaplains in IOPs for PTSD treatment throughout the military services (e.g., Hoyt et al, 2018). The current article explored how chaplains and clinicians may use differing treatment approaches that can complement each other in offering service members more integrated, holistic care.…”

The core competency model for corrections: An education program for managing self-directed violence in correctional institutions.

“…Gatekeeper trainings are one public health approach to SDV prevention (e.g., Holmes et al, 2021; Wolitzky-Taylor et al, 2020). These trainings, such as Question, Persuade, Refer (QPR; QPR Institute, n.d.), train lay persons in basic skills (e.g., recognizing suicide warning signs) and can apply to general populations or populations requiring special considerations (e.g., military; LaCroix et al, 2021). Gatekeeper programs demonstrate positive impacts in enhancing suicide prevention knowledge, self-efficacy, and intervention behavior (e.g., Hangartner et al, 2019; Litteken & Sale, 2018).…”